Provider Demographics
NPI:1457558793
Name:TURMO, CHRISTA SELENE (MLT)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTA
Middle Name:SELENE
Last Name:TURMO
Suffix:
Gender:F
Credentials:MLT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6297
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85312-6297
Mailing Address - Country:US
Mailing Address - Phone:623-340-2146
Mailing Address - Fax:623-463-7930
Practice Address - Street 1:8518 N. 64TH AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85302
Practice Address - Country:US
Practice Address - Phone:623-340-2146
Practice Address - Fax:623-463-7930
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor